ESIS Claims Representative, WC

Chubb Insurance; Town of Cheektowaga (NY); Híbrido; USD 52.000 - 78.000; Jornada completa

Descripción de la vacante

Chubb Ltd. is seeking an ESIS Claims Representative for workers' compensation to investigate and settle claims promptly. The role supports a hybrid work model with 3 days in office and 1 day remote, located in Cheektowaga/Philadelphia areas.

You will gather statements, assess policy obligations, and coordinate with experts to resolve claims efficiently. Under the Claims Team Leader, you will prepare investigations, set reserves, and report outcomes while maintaining strong relationships with

Responsabilidades

• Receive new assignments.
• Review claim and policy information to determine policy obligations.
• Contact insureds, claimants, witnesses, physicians, attorneys, police officers for information.
• Arrange surveys and experts where appropriate.
• Evaluate facts to determine liability and company obligations.
• Prepare reports on investigations, settlements, denials, and evaluations.
• Set reserves within authority limits and discuss changes with Team Leader.
• Review progress with Team Leader and discuss remedial actions.
• Manage litigation files timely and appropriately.
• Assist Team Leader in developing methods for handling claims.
• Settle claims promptly and equitably.
• Obtain releases, proofs of loss, or compensation agreements; issue drafts for payments.
• Inform claimants of denials when applicable.
• Assist in preparing cases for trial by arranging witness attendance and statements.
• Refer claims to subrogation as appropriate.
• Participate in file reviews and audits with customers and insureds and brokers.
• Administer benefits and maintain control of resolution process to minimize exposure and risk.
• Establish and maintain strong customer relations with agents, underwriters, insureds, and experts.
• Maintaining system logs
• Investigating compensability and benefit entitlement
• Reviewing and approving medical bill payments or forwarding for outside review as necessary
• Managing vocational rehabilitation

Descripción del empleo

ESIS Claims Representative, WC

Locations: Cheektowaga, VA | Philadelphia, PA

Work Arrangement

This role follows a hybrid schedule of 3 days in office and 1 day remote.

Key Objective

Under the direction of the Claims Team Leader, investigates and settles claims promptly, equitably, and within established best practices guidelines.

Major Duties & Responsibilities

Duties may include, but are not limited to:

• Receive new assignments.


• Review claim and policy information to provide background for investigation and determine the extent of the policy’s obligation to the insured, depending on the line of business.


• Contact, interview, and obtain statements, recorded or in person, from insureds, claimants, witnesses, physicians, attorneys, police officers, and others to secure necessary claim information.


• Arrange for surveys and experts where appropriate.


• Evaluate facts supplied by investigation to determine the extent of liability of the insured, if any, and the company’s obligation to the insured under the policy contract.


• Prepare reports on investigations, settlements, denials of claims, and individual evaluations of involved parties.


• Set reserves within authority limits and recommend reserve changes to the Team Leader.


• Review progress and status of claims with the Team Leader and discuss problems and suggested remedial actions.


• Manage litigation files in a timely and appropriate manner.


• Assist the Team Leader in developing methods and improvements for handling claims.


• Settle claims promptly and equitably.


• Obtain releases, proofs of loss, or compensation agreements and issue company drafts for claim and expense payments.


• Inform claimants, insureds, customers, agents, or attorneys of claim denials when applicable.


• Assist the Team Leader and company attorneys in preparing cases for trial by arranging witness attendance and taking statements; continue efforts to settle claims before trial.


• Refer claims to subrogation as appropriate.


• Participate in claim file reviews and audits with customers and insureds and brokers.


• Administer benefits timely and appropriately, maintaining control of the claim resolution process to minimize current exposure and future risks.


• Establish and maintain strong customer relations with agents, underwriters, insureds, and experts.

Depending on Line of Business, Other Duties May Include

• Maintaining system logs


• Investigating compensability and benefit entitlement


• Reviewing and approving medical bill payments or forwarding for outside review as necessary


• Managing vocational rehabilitation

Scope Information

The position reports directly to a Claims Team Leader or other member of claims management.